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Quitting gets easier.
The news is getting better for people who want to quit smoking. Although it is well established that 60 to 90 percent of smokers who quit relapse within a year, a new study at the BU Schools of Public Health and Dental Medicine reveals that among ex-smokers who stick it out for two years, the relapse rate drops dramatically -- to 2 to 4 percent a year. Among those who stay smoke-free for 10 years, less than one percent a year return to smoking.

The study, conducted by Elizabeth Krall, an associate professor at SDM, Raul Garcia, an SDM professor and chairman of the health policy and health services research department, and Arthur Garvey, an SPH assistant professor, draws upon data collected from 483 men who were monitored over a 35-year period as part of the Veterans Administration Normative Aging Study. Beginning in 1963, the subjects were evaluated every three years with physical examinations and questionnaires that probed such behaviors as smoking, alcohol use, and caffeine consumption as well as recorded socioeconomic information about the subjects.

The authors found that heavy coffee drinkers (more than six cups a day) and cigar or pipe smokers were most likely to return to smoking. Heavy drinkers (more than five alcoholic drinks a day) were also more likely to relapse; moderate drinking, however, was not significantly associated with a return to smoking.

This research, the first to focus on late smoking relapse, was published in the current issue of Nicotine & Tobacco Research.

Clear!
Millions have watched as doctors, paddles in hand, shout, "Clear!" -- shocking patients back to life on ER and other television medical dramas. Now the American Heart Association and the American College of Sports Medicine are urging health clubs and fitness centers to provide training to their personnel in the use of a new generation of defibrillators known as AEDs (automated external defibrillators) and to have them on hand in case of sudden cardiac arrest on the workout floor.

In a joint statement in the March 5 issue of Circulation: Journal of the American Heart Association, the two medical organizations recommend AEDs as standard equipment at health clubs and fitness centers.

"The first few minutes after a cardiac emergency are crucial to survival," says Gary Balady, a professor of medicine at the BU School of Medicine, who chaired the group that drafted the statement. As the number of people who exercise at health and fitness clubs grows, so does the number of people at risk for a cardiac emergency, including senior citizens and people with undiagnosed heart disease. Although the overall risk is low, being prepared is important, Balady emphasizes.

In most cases cardiac arrest leading to sudden death is preceded by ventricular fibrillation, a condition where the electrical impulses in the diseased heart become extremely rapid or chaotic, or both. The irregular rhythm causes the heart to suddenly stop beating. AEDs are designed to analyze the rhythm of the heart and let the caregiver know whether to deliver an electrical shock to the victim. The shock can defibrillate the heart, literally jolting it back into a normal rhythmic pattern. When defibrillation is achieved within the first minute after cardiac arrest, survival rates of as much as 90 percent have been reported. For every minute that defibrillation is not delivered, survival rates drop between 7 and 10 percent. After 12 minutes without defibrillation, a person's chance of survival drops to only between 2 and 5 percent.

The number of Americans who exercise regularly at fitness clubs has increased steadily in recent years -- to as many as 30 million. Nearly 55 percent of these people are over age 35, according to one survey, and, say the authors, it is reasonable to assume that the number of members with undiagnosed cardiovascular disease is rising as well.

The good news is that by exercising and keeping fit, people decrease their risk of a cardiac emergency, and by stocking AEDs and training their staff in CPR and other lifesaving techniques, fitness centers can decrease the risk of death in case of an emergency.

The full text of the joint statement is available online at: http://circ.ahajournals.org/cgi/content/full/105/9/1147.

"Research Briefs" is written by Joan Schwartz in the Office of the Provost. To read more about BU research, visit http://www.bu.edu/research.

15 March 2002
Boston University
Office of University Relations